Individual provider Active NPI

Ryan Nathan, AA-S

  • Anesthesiologist Assistant
  • Oklahoma City, OK
National Provider Identifier
1508476367
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
34 Issued in OK
Practice address
5030 N May Ave
Oklahoma City, OK 73112-6010
Phone
(405) 951-2815
Fax
(405) 951-2495
NPI assigned
Aug 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 34 OK Primary

Addresses

Primary practice location

5030 N May Ave
Oklahoma City, OK 73112-6010

Mailing address

PO Box 840848
Dallas, TX 75284-0848
Phone (972) 283-1999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210414001410 OK Practitioner - Anesthesiology Assistant 2163837345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medical Professionals PLLCGroup PAC ID 5991970279, 103 clinicians

Practice addresses (Care Compare)

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 713-4565

Hospital & facility affiliations

  • Integris Baptist Medical Center, Inc Hospital, Oklahoma City, OK, CCN 370028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Associate of Applied Science

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Professionals, PLLC CurrentSince Jan 16, 2023 Accepting new patients

Locations

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

3300 NW Expressway St
Fl 2
Oklahoma City, OK 73112
Phone (405) 251-2815

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1508476367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840848",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840848",
            "telephone_number": "972-283-1999",
            "fax_number": "972-233-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 N MAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731126010",
            "telephone_number": "405-951-2815",
            "fax_number": "405-951-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "AA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OK",
            "license": "34",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.